Int J Clin Pediatr

International Journal of Clinical Pediatrics, ISSN 1927-1255 print, 1927-1263 online, Open Access

Article copyright, the authors; Journal compilation copyright, Int J Clin Pediatr and Elmer Press Inc

Journal website https://www.theijcp.org

Case Report

Volume 9, Number 4, December 2020, pages 125-129

Elevated Lipase Associated With COVID-19 Possibly due to Acute Pancreatitis in a Pediatric Patient: A Case Report

Figure 1. Computed tomography of the abdomen and pelvis showing an indistinct margin of the pancreatic tail and left upper quadrant ascites. Mild stranding (white arrow) with surrounding ascites (red arrow).

**Table 1.** Complete Blood Count
	Hospital day 1	Hospital day 2	Hospital day 3
WBC: white blood cell; RBC: red blood cell; Hb: hemoglobin; HCT: hematocrit; MCV: mean corpuscular volume; MCH: mean corpuscular hemoglobin; MCHC: mean corpuscular hemoglobin concentration; MPV: mean platelet volume; RDW-CV: red blood cell distribution width.
WBC (× 10³/mm³)	9.8	9	9.4
RBC (× 10⁶/mm³)	5.31	5.08	5.05
Hb (g/dL)	14.7	14	13.9
HCT (%)	43.6	42.1	41.9
MCV (fL)	82.1	83	83
MCH (pg)	27.7	27.6	27.5
MCHC (g/dL)	33.8	33.2	33.1
MPV (fL)	9.1	9.1	9
RDW-CV (%)	14.5	14.5	14.1
Platelet count (× 10³/mm³)	204	195	193
Neutrophils (%)	84	76.4	79.7
Lymphocytes (%)	11	13.3	9.7
Monocytes (%)	4	9.8	9.9
Eosinophils (%)	1	0.1	0.2
Basophils (%)	0.0	0.4	0.5
Absolute neutrophils (× 10³/mm³)	8.23	6.9	7.5
Absolute lymphocytes (× 10³/mm³)	1.08	1.2	0.9
Absolute monocytes (× 10³/mm³)	0.39	0.9	0.9
Absolute eosinophils (× 10³/mm³)	0.1	0.0	0.0
Absolute basophils (× 10³/mm³)	0.0	0.0	0.0

Table 1. Complete Blood Count

Hospital day 1

Hospital day 2

Hospital day 3

WBC: white blood cell; RBC: red blood cell; Hb: hemoglobin; HCT: hematocrit; MCV: mean corpuscular volume; MCH: mean corpuscular hemoglobin; MCHC: mean corpuscular hemoglobin concentration; MPV: mean platelet volume; RDW-CV: red blood cell distribution width.

WBC (× 10³/mm³)

9.8

9.4

RBC (× 10⁶/mm³)

5.31

5.08

5.05

Hb (g/dL)

14.7

13.9

HCT (%)

43.6

42.1

41.9

MCV (fL)

82.1

MCH (pg)

27.7

27.6

27.5

MCHC (g/dL)

33.8

33.2

33.1

MPV (fL)

9.1

RDW-CV (%)

14.5

14.1

Platelet count (× 10³/mm³)

204

195

193

Neutrophils (%)

76.4

79.7

Lymphocytes (%)

13.3

9.7

Monocytes (%)

9.8

9.9

Eosinophils (%)

0.1

0.2

Basophils (%)

0.0

0.4

0.5

Absolute neutrophils (× 10³/mm³)

8.23

6.9

7.5

Absolute lymphocytes (× 10³/mm³)

1.08

1.2

0.9

Absolute monocytes (× 10³/mm³)

0.39

0.9

Absolute eosinophils (× 10³/mm³)

0.1

0.0

Absolute basophils (× 10³/mm³)

0.0

**Table 2.** Complete Metabolic Panel
	Hospital day 1	Hospital day 2	Hospital day 3
BUN: blood urea nitrogen; ALP: alkaline phosphatase; AST/SGOT: aspartate aminotransferase; ALT/SGPT: alanine aminotransferase; CO₂: carbon dioxide.
Protein (g/dL)	7.7	6.5	6
Albumin (g/dL)	4.4	3.8	3.6
BUN (mg/dL)	8	7	7
Creatinine (mg/dL)	0.85	0.83	0.86
Calcium (mg/dL)	9.7	9.1	8.9
Glucose (mg/dL)	120	121	95
Total bilirubin (mg/dL)	1.6	1.9	2.8
ALP (U/L)	430	356	323
AST/SGOT (U/L)	20	16	14
ALT/SGPT (U/L)	11	6	7
Sodium (mmol/L)	136	137	136
Potassium (mmol/L)	4.1	3.9	4.3
Chloride (mmol/L)	102	105	104
CO₂ (mmol/L)	28	28	26
Anion gap	6	4	6
Phosphorus (mg/dL)		5
Magnesium (mg/dL)		1.84

Table 2. Complete Metabolic Panel

Hospital day 1

Hospital day 2

Hospital day 3

BUN: blood urea nitrogen; ALP: alkaline phosphatase; AST/SGOT: aspartate aminotransferase; ALT/SGPT: alanine aminotransferase; CO₂: carbon dioxide.

Protein (g/dL)

7.7

6.5

Albumin (g/dL)

4.4

3.8

3.6

BUN (mg/dL)

Creatinine (mg/dL)

0.85

0.83

0.86

Calcium (mg/dL)

9.7

9.1

8.9

Glucose (mg/dL)

120

121

Total bilirubin (mg/dL)

1.6

1.9

2.8

ALP (U/L)

430

356

323

AST/SGOT (U/L)

ALT/SGPT (U/L)

Sodium (mmol/L)

136

137

136

Potassium (mmol/L)

4.1

3.9

4.3

Chloride (mmol/L)

102

105

104

CO₂ (mmol/L)

Anion gap

Phosphorus (mg/dL)

Magnesium (mg/dL)

1.84

**Table 3.** Additional Serum Studies
HIV: human immunodeficiency virus; RPR: rapid plasma reagin.
Gamma-glutamyl transferase	15 U/L
Amylase	104 U/L
Triglycerides	43 mg/dL
HIV 1/2 antibody 4th generation screening	Non-reactive
RPR for syphilis	Non-reactive
Blood culture	Negative
Urine Chlamydia trachomatis and Neisseria gonorrhoeae	Negative

Table 3. Additional Serum Studies

HIV: human immunodeficiency virus; RPR: rapid plasma reagin.

Gamma-glutamyl transferase

15 U/L

Amylase

104 U/L

Triglycerides

43 mg/dL

HIV 1/2 antibody 4th generation screening

Non-reactive

RPR for syphilis

Non-reactive

Blood culture

Negative

Urine Chlamydia trachomatis and Neisseria gonorrhoeae

Negative

**Table 4.** Urinalysis
	Hospital day 1	Hospital day 2
WBC: white blood cell; HPF: high power field; LPF: low power field.
Glucose	Negative	Negative
Blood	Negative	Negative
Bilirubin	Small	Negative
Ketones	Trace	Negative
Urine specific gravity	≥ 1.030	≥ 1.031
PH	6.0	5.0
Protein (mg/dL)	100	30
Urobilinogen (EU/dL)	0.2	< 2.0
Leukocyte esterase	Negative	Negative
Nitrites	Negative	Negative
WBC		2 - 5/HPF
Bacteria		Few
Mucus threads		3+/LPF

Table 4. Urinalysis

Hospital day 1

Hospital day 2

WBC: white blood cell; HPF: high power field; LPF: low power field.

Glucose

Negative

Blood

Negative

Bilirubin

Small

Negative

Ketones

Trace

Negative

Urine specific gravity

≥ 1.030

≥ 1.031

6.0

5.0

Protein (mg/dL)

100

Urobilinogen (EU/dL)

0.2

< 2.0

Leukocyte esterase

Negative

Nitrites

Negative

WBC

2 - 5/HPF

Bacteria

Few

Mucus threads

3+/LPF